Posted
by
timothy
on Sunday May 25, 2014 @07:35PM
from the both-at-once-is-just-asking-for-it dept.

That smoking is bad for your health is a commonplace; cancer, lung disease, and other possible consequences can all shorten smokers' lifespans. A new meta study from researchers at Oxford concludes that mental illness is just as big a factor in shortening lives, and not only because depression is a contributing factor to suicide.
From the story at NPR: "We know that smoking boosts the risk of cancer and heart disease, says Dr. Seena Fazel, a psychiatrist at Oxford University who led the study. But aside from the obvious fact that people with mental illnesses are more likely to commit suicide, it's not clear how mental disorders could be causing early deaths. The researchers looked at data on 1.7 million patients, drawing from 20 recent scientific reviews and studies from mostly wealthy countries. Comparing the effects of mental illness and smoking helps put the stats in context, Fazel tells Shots. 'It was useful to benchmark against something that has a very high mortality rate.'" [Press release from Oxford.]

Perhaps the reduced life expectancy is comparable to that caused by high-stress lifestyles. If I was paranoid or socially ostracised, as the mentally ill commonly are, I'd be stressed too.

I would also add that mental illness & stress also reduce the ability of those afflicted to care for themselves, resulting in unhealthy lifestyle choices, and drives away those who might want to help as well.

As someone with untreated clinical depression and a sleep disorder (or just with one and the other as a symptom) I agree with the parent and his smart grandparent. "Mental illness" can be extremely stressful. I see too many choices and it takes a long time to come up with the best choice. Deciding takes too long which eats up my already shortened time. As my time disappears more and more tasks start piling up Too many tasks makes me feel overwhelmed and I break down and use escapism to avoid my seemingly impossible things to do (each task for you would take 10-30 minutes to complete). I was at least able to stop playing video games, but now I'm watching way too much TV (currently on Red Dawn and slowly moving backwards through highly rated scf-fi TV shows after finishing all the well known shows).

I get very little accomplished with all that procrastinating, which makes me feel even more depressed. I do try and get out with people, but after a night of dance club I cry myself to sleep from the stress of dealing with people and all the mistakes I made screwing up dance moves I should have known, knowing I'm a loser because I was standing on the side lines waiting for someone to ask me to dance instead of having the confidence to ask them, or people telling me I should smile more. Really please stop that. The last thing I need you to tell me is that I'm making everyone around me feel bad because I don't look happy enough. That reduces my confidence even further because then I believe everyone is bothered by me and doesn't want me around. True or not, it increases escapism and reduces healthier activities.

How would you like to walk barefoot through a large area converted with poisonous snakes? That's what it's like all the time with crippling social anxiety. Anything you do and your inactions must be perfect or you'll be destroyed by those around you. Since just being in such a situation is extremely stressful in and of itself, you'll make mistakes.

One obvious additional factor is needing to take medications. Medications are a form of drug, and they do alter body chemistry etc from someone that doesn't need it. Not for a minute am I saying that people who have mental illness should be off their meds, but it is the lesser of two evils when compared to a healthy person.

That may be true on a statistical level however I personally know 4 people (plus their immediate family members) who lives were turned upside down by a combination of Zoloft (anti-stress) mixed with regular, but not excessive, alcohol consumption (anti-inhibitor). One of them (a 60yr old male with no police record) ended up in jail for attacking some cops, another (40yo male) was arrested and thrown into the local lock-up for threatening neighbours and the police who turned up to investigate.

If antidepressants are really the answer, why does America, with one of the highest rates of antidepressant use, also have one of the highest rates of depression in the world? If they were really effective, people should be less depressed, and in fact there's more depression and mental illness than ever. There's increasingly concern that antidepressants are actually making things worse. In the short term, antidepressants can be effective in managing the treatment of depression, for some people. The problem is that they can cause long-term changes in how the brain functions, such that the person becomes dependent upon the drug. This means that on quitting antidepressants, the depression is more likely to return than it would have been if it had simply been left to resolve itself. There have been a number of studies published that suggest that the long-term outcome of mental illness is worse when antidepressants are used. As far as I know, there isn't a single study that has shown that outcomes for depression are improved long-term- over the course of 5-10 years instead of 5-10 weeks- by the use of antidepressants.

Maybe antidepressants do have a role in treating mental illness, but given the risks- increased risk of suicide, the highly addictive nature of some of the drugs (especially ones with short half-lives) and the risk that they can make people worse than when they started, these should be a method of last resort for severe clinical depression, NOT a first-line treatment for everyone who seems moderately sad or anxious. There are a *lot* of things that have been shown to be potentially beneficial- cognitive behavioral therapy, exercise, light therapy, sleep therapy, and supplements like Omega 3 fatty acids, vitamin B, D, zinc and magnesium, cutting down on carbohydrates- which come without the risks posed by antidepressants.

I took some anti-anxiety meds for a little bit, but I'm a very introspective person and found my shift in reasoning scary to the point if it causing more anxiety. I'm very conscience of my thoughts, and shifts in my thinking makes me reexamine myself.

America has one of the highest antidepressant use in the world because it qualifies you for social security when you're unemployed for a long time, and have bills to pay. It's like this: are you broke? We got a pill for that too!

Listen to me please: your writing indicates a typical depressed thought pattern, trust me, I've been there - I've been worse than that. I've talked with people with depression and noticed the same things/patterns.

Guess what? Anti-depressants aren't intended to treat the _cause_ of depression. They aren't meant to be a "lucky pill" (a common meme) - they don't make one happy and aren't intended to. What they do is enabling the brain to work more as it is intended to and enable one to do other things to improve ones situation. However they need to be taken long term in order to do anything so taking them for a month and then quitting because "they don't do anything" that some people do isn't so smart.

If one is very depressed and want a quicker acting help I'd recommend ECT - Electroconvulsive Therapy. I've had it in several rounds and talked with people that also had it periodically, some for many years (chronic depression). It is extremely quick acting compared to pills, some people claim to feel better already after waking up from the (for civilized nations) mandatory sedation.Is it risk free? No, _no_ treatment is risk free. People have died from complications when treating ingrown nails. ECT isn't good if one have very high blood pressure for instance as the pressures increase sharply, there are a number of other contraindications too. But ECT is the treatment with the most FUD around. It doesn't change one's personality, one doesn't suffer total memory loss, one doesn't get severe brain damages.Memory loss is a common side-effect though but it is mostly short term and is compensated by the practitioner adjusting placement of electrodes and the parameters for the next treatment. Another is muscle ache however that is compensated for using a mild muscle relaxant in conjunction with the sedation.

About anti-depressants destroying the brain I'll not comment on directly however do you realize that depression _does_ destroy the brain? That is one reason for the faulty thought patterns and is easily verifiable by MRI on deeply depressed people. Anti-depressants and ECT have been shown to regrow lost brain matter.These are verified findings from 3rd party BTW so not some company PR.

For your own sake I hope you do seek treatment, it can improve your quality of life drastically. I'm not talking about everything getting perfect over night, it will most likely take long time and well, is there anybody with a perfect life?;) But it can be much better.

PS if you have problem discussing your problems (AFAIK pretty common for depressed people) I recommend writing them down on a paper when seeking treatment and giving it to the psychologist. In this way he/she can then easier ask relevant questions.

The medication thing is an interesting issue. I've personally encountered the following:
I just want a pill that's going to solve everything
Nothing I've taken has helped me, and the side effects can be hellish, and I'm tired of the not knowing and waiting to see if the next drug is going to work or not
I'm scared of the side effects, and especially that they will affect my cognitive function or personality
I don't want to be dependent on a pill for the rest of my life
I'm feeling better, so I'm going to s

Regarding getting things done: you could also try a task/reward model. A lot of behaviour change can center around patterning. Getting started is the hardest part of course, but if you start small and basically force yourself into a positive loop, a pattern is a good behaviour modifier.Things to get done? Make a small checklist. For example if you wanted to improve physical health, you could add some basic exercise (say 5-10 push-ups). Add a few other small tasks like "walk the dog", "water the plants" etc.

You didn't mention whether or not you had a job. I suffered for years but soldiered through supporting my family. At 58 my youngest was almost through college and my wife had a job so one day, after weeks of only sleeping four hours a night I quit doing anything. Several years of taking medication only kept me from jumping off a bridge. After I was able to get disability payments I now only take Ambien for the sleep disorder but I still have the extreme procrastination problem. I can't tell you to just get

There's a pretty high level of suicides among schizophrenics. If the schizophrenia is severe, they can also engage in dangerous behavior, like walking into traffic or onto subway tracks.

I would think that people with mental illnesses are more likely to die from accidents, because they may not react as quickly or correctly to a dangerous situation. Not necessarily because of being slow or stupid (although those count too), but they may have other things on their mind. Or may be on medication that affects the ability to react correctly.

100% Yes agree with that. If you have a mental illness you are the biggest outcast ever. If you last 5 limbs you have a better chance of people treating you better then those that have a variety of mental illnesses.

One of the big problems is that anti-psychotic drugs have severe, and sometimes fatal, side effects. (Many of them cause severe weight gain, often enough to lead to diabetes.)

It's actually difficult or impossible to find out whether a drug causes, say, fatal heart attacks, if they didn't show up with 1% frequency in 500 patients in 6 months in the original FDA approval trials.

World Psychiatry is an open access journal, but that issue isn't on its web site yet. http://www.wpanet.org/detail.p... [wpanet.org] So I can't read the article and find out whether they deal with this.

I had a friend who was schizophrenic. He had finished a couple of years at Columbia before the schizophrenia hit. Fortunately his parents were relatively wealthy, and they could put him up in an apartment with a relatively normal lifestyle. He had a girlfriend. They smoked a lot of marijuana.

One day he died suddenly, for no apparent reason. I think the final diagnosis was a heart attack. His psychiatrist insisted that it wasn't the drugs that did it, but I later found out that his drugs were associated with some fatalities.

I'm not saying that you shouldn't treat schizophrenia with drugs, but I am saying that there's a tradeoff.

Sometimes when people with schizophrenia refuse to take drugs, it's because they decided that they'd rather suffer the symptoms than the side effects of the drugs. Sometimes that can be a reasonable choice. If I were faced with tardive dyskenesia, I might go with the symptoms of schizophrenia. If I were faced with gaining another 100 pounds, I might go with the symptoms of schizophrenia.

One of the big problems is that anti-psychotic drugs have severe, and sometimes fatal, side effects. (Many of them cause severe weight gain, often enough to lead to diabetes.)

The idea that weight gain causes (T2) diabetes has two obvious flaws. The first is that there are plenty of obese non diabetics. The second is that at least 20% of people diagnosed T2 are "slim". This being a case of "correlation does not imply causation".Also diet is going to be a factor here. Someone frequently in hospital or just

The ubiquitous use of medications like mood stabilisers (lithium and valproate) and neuroleptics (called antipsychotic by pharma marketing) need their bit of attention. The demotivating effect of these drugs causes many to lose interest in taking care of themselves, and that knock-on effect can most likely shorten lives. But with so much mental health 'research' funded by big pharma it is unlikely that enough good unbiased research will be done in the area, certainly not enough to counter the sheer weight

I can nail this one: Mentally ill people generally don't take good care of themselves. They tend to eat worse and more irregularly, sleep odd hours, and not get to the doctor as much (for whatever reason), especially if they live by themselves and no one's looking after them.

Your phrasing makes it sound like it's voluntary. Mentally ill people are often unable to make choices because of their illness, and so as a result, it's not a choice, it's just doing enough to get by.

The rhetoric of "choice" and "responsibility" is quasi-religious anyway, with no basis in science.

The human mind is very far from rational, and what little neurological evidence we have suggests we may make decisions before we have even become consciously aware of them - it's just really good at tricking itself into thinking it is a magically rational computer.

Rather than an artificial, binary divide between the capable and the incapable, it would be much better if we thought on a sliding scale in terms of some people being programmed to manage certain affairs better than others, and recognised that there is no fault beyond birth.

Your phrasing makes it sound like it's voluntary. Mentally ill people are often unable to make choices because of their illness, and so as a result, it's not a choice, it's just doing enough to get by.

Doesn't really make much difference, does it? It doesn't matter whose fault it is, in the end, the depressed person is the one that suffers. That's why worrying about blame is silly.

Your phrasing makes it sound like it's voluntary. Mentally ill people are often unable to make choices because of their illness, and so as a result, it's not a choice, it's just doing enough to get by.

True, also mentally ill people often have trouble getting good jobs if any jobs at all. Many live on government assistance and are well below the poverty line. And it is well known that poverty is correlated with a shorter lifespan. Many simply cannot afford healthy lifestyle choices, such as nutritious food or preventive medical care.

also mentally ill people often have trouble getting good jobs if any jobs at all

The article headline and so many of the replies, including yours, seem to just focus on
a tiny subset of mental illness. STOP THE NEGATIVE STEREOTYPES

Sure, people who suffer severe and extreme levels of depression do have trouble with these things.

But mental illness covers a huge swath of conditions.

That skinny girl who has anorexia, that is a mental illness. That person who keeps his desk really neat at work has mild OCD which is a mental illness. Chances are very good that your boss or your grand-boss

Mod way up. I have a relative who has moderately severe schizophrenia. Unable to make good decisions is exactly what this condition causes. Add in some paranoid delusions and you have a person who seems perfectly ok (on a good day) but is utterly incapable of functioning in society.

Mentally ill people generally don't take good care of themselves. They tend to eat worse and more irregularly, sleep odd hours, and not get to the doctor as much (for whatever reason), especially if they live by themselves and no one's looking after them.

In addition to the poor choices associated with irrationality... remember that these are diseases of the brain. Complex syndromes that have effects beyond behavior and thinking. For example, depression is associated with pain.

The mentally ill are over-represented in homeless, impoverished, drug-using (self-medicating), and other highly at-risk populations. Even with a support network, they are often unable to assist in their own care, and symptoms they describe may be attributed to excessively attributed to psychosomatic rather than physical causes. They often refuse medical care, either blanket refusal, or may specifically refuse to take one medication, or follow one bit of doctor's advice. They usually have difficulty retaining a doctor, and bounce between them, probably to progressively less-capable ones.

The reasons are "are little understood and likely to be complex," say Dr. Hoang and colleagues, but "are likely to be influenced by adverse lifestyle and social factors associated with the presence of mental illness such as alcohol and illicit drug use, and exposure to poor housing."

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.

I don't have the figures for 2004, but I do have the figures for 2012 regarding homelessness. From the US Department of Housing and Urban Development:

On a single night in 2012 there were 633,782 homeless people in the United States[...]

Dividing by the US population in 2012 (312.8 million), we get 0.00202615728, or, 0.2%

So 26.2% of Americans are mentally ill, and 0.2% of Americans are homeless. So no, it's not a "positively idiotic statement." The mentally all are all around us, and perhaps the reason the st

It is amazing at how quickly people jump from the word "mental illness" to "homeless, homicidal, criminally insane."

The vast majority of humanity has a mental illness at least one in their life. It may be trouble coping with a death. It may be trouble overeating or starving yourself. Most executives, politicians, and a large number of law enforcement officers are all sociopaths. Even issues like premature ejaculation can be linked to mental illnesses, either short term or long term.

An estimated 26.2 percent of Americans ages 18 and older â" about one in four adults â" suffer from a diagnosable mental disorder in a given year.

At that rate, the word loses all meaning, and I don't believe for a second that this higher mortality rate is reflected in over a quarter of the population. Instead, you're using an extremely wide definition.

Your comment is completely misinformed

No. I even quoted a relevant expert at the end of my rant, which largely supports exactly what I said.

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.

I don't have the figures for 2004, but I do have the figures for 2012 regarding homelessness. From the US Department of Housing and Urban Development:

On a single night in 2012 there were 633,782 homeless people in the United States[...]

Dividing by the US population in 2012 (312.8 million), we get 0.00202615728, or, 0.2%

So 26.2% of Americans are mentally ill, and 0.2% of Americans are homeless. So no, it's not a "positively idiotic statement." The mentally all are all around us, and perhaps the reason the study can't pin down why they're dying younger is because people are under the impression that you can easily spot someone who's mentally ill. Yeah, a lot of homeless people are mentally ill. But about a quarter of everyone is mentally ill, and trying to put the mentally ill into a box means that most of those people will go untreated because they'll be ashamed of their disease.

Pretty much by definition, the severity of a mental illness is measured by the degree of impairment to your life.

So let's not conflate the large numbers of people diagnosed with relatively mild degrees of mental illness with the seriously mentally ill. The seriously mentally ill are quite disproportionately homeless, unemployed, dependent upon others, etc.

The inability to manage one's own affairs and to get along with others is, not surprisingly, detrimental to other aspects of health.

You're quite right, but there are other, more direct pathways to death that mental conditions can lead you onto. There's been a lot of research recently into how mental state interplays with normal physiology, such as the immune system. It could very well be that even in the absence of the things you're mentioning, mentally ill people are compromised when dealing with ordinary diseases, for example.

It simply means that there is not enough scientific data to support any hypothesis conclusively, not that they have no clue whatsoever. Do you have any data to back up your hypothesis or is it just "common sense"?

Certainly, psychotropic medications can have some pretty serious side effects.

On the other hand, they are used to treat very serious illness. Many of the symptoms of mental illnesses are dangerous. As with all medications, there is a trade off between the benefit of the medication and the detriment of the side effects.

The meds you mention, Thorazine and haloperidol, are pretty old school BTW. These days newer atypical antipsychotics would usually be tried first.

AFAIK, nicotine acts in a similar fashion to monamine oxidise inhibitor (MAO) mood stabilizers. It can be administered as required, and the dose easily controlled. I wonder if we could get the same benefits by vaping, while losing some of the negative health consequences?

It's not the nicotine. There's naturally occurring substances in tobacco that are MAOI's. That's probably why a lot of people aren't able to switch to vaping. For me personally, it's most noticeable when drinking - a real cigarette is far more satisfying, even though totally sober vaping does it for me.

Why do people insist on studying, helping, fixing the mentally ill or the drug abusers? What about those who are "healthy" but run into unfortunate events (car crash, cancer, getting laid off)? If we're going to treat society as a single organism, wouldn't we want to give to the most capable rather than the least? Where is this constant need to fix people coming from?

A number of reasons1) Basic human compassion2) Mentally ill and drug abusers affect the healthy. Drug crime is rampant with a high cost to society. Even if all drugs were legalized, as I believe they should be, there would be still a heavy price, just as with alcoholism. These would include car crashes, unemployment, failed businesses, etc that you mention.3) As someone with depression, it seems worth fixing.4) Mental illness is just that, an illness.Why do you draw a distinction between cancer and mental illness. How is someone with cancer "healthy"?

Well, it costs $60k/year to keep people in prison, why not just pay them $50k/year as long as they stay out of trouble? It would be a net savings of $10k/year, plus free up man power from guards, expanding the economic pie. Of course life isn't this simple, but it is a naive example of the concept of helping people to save money. Not helping people tends to increase crime, which is more expensive in real money and even worse once you include the opportunity costs.

Poor health can contribute to or directly relate to mental illness. Some in the study probably suffered from other illness but were not diagnosed. It must be just fraction of the measurement but it might be an important one.

Diagnosed mentally ill people tend to get psychopharmaceutic medication, stuff that kidneys and liver have a hard time dealing with intentionally since it needs to accumulate and thus maintain a somewhat constant level in the bloodstream.

So how many of those deaths are attributable to liver or renal failure?

Leftist ideology is based (and this is provable) on voluntary insanity. The fact that he is a leftist and goes around calling other people crazy (as is implied by his comment) is pretty good evidence that he is projecting. I wasn't sure if he knew that he was doing that. So I provided him with a link to help him learn about his (possibly self-imposed) condition. The link didn't prove anything. It was only there to help him start reflecting on what he was doing.

Psychiatric medications cause obesity, high blood pressure and diabetes (metabolic disorders) and shorten life span by 15 - 25%. It's important to separate effects of illness and effects of treatments for illness.

Since this is a meta-analysis, it doesn't take into account a lot of other factors; many people with mental illness come from or end up in lower socioeconomic places.
But more than anything else, people with mental illness SMOKE. Not all of them, and not all the time, but tobacco usage among the mentally ill is 70% higher according to the CDC than it is amongst everyone else. In this case the correlation is almost a doozy.

I'm severely depressed, due to severe guilt and shame over things that happened in the past, although I've learned ways to hide this from most of those who don't know me. Drugs have never worked (over a 20+ year period of trying many). And frankly I don't expect to live long because I don't want to live long. My depression is at least as much a burden to my family as it is to me. They are relatively young and deserve a fresh start, with someone better than me. Though I lack the courage to end my life q

Now, if we could ONLY get him to understand basic math better (like 244 is greater than 1)

Is that all you got, APK? Really? Loser.

How do you figure? Oh, that's right - you don't! Basic math eludes you. Clue: 244 of your/. peers proved you wrong vs. your 1 and you lose again to the SUPERIOR, apk.

Well then, superior arsehole APK, perhaps you can explain your 'basic working' then? How exactly do 244 up-mods counter my opinion of you? What is this '1' that you speak of? Have you forgotten all the other people who have very low opinions of you? What about all the down-mods you've received? Your data is meaningless without that, loser.

I remember the last time I heard someone say "not!" like you do all the time - it was in school. That's right - your behaviour is visible to all for what it is.

Oh, and as for my use of language, yup, it's just what you deserve. Actually, what you really deserve is to be skinned - very slowly - over a fire. Fortunately for you that's illegal and I'm in another country, so swearing at you is going to have to do. Hope that's ok!:-)

There are probably reasons but it will not be as obvious as that. Some of these countries have real reasons to be depressed or suffer anxiety disorders and yet score low in a survey by the WHO. Japan for instance has numbers so low the research said it is unbelievable and it is highly capitalist.

In japan, mental illness carries a high stigma, so it is not talked about. Note in the article you pointed to, the reported figure is implausibly low, but the use of benzos (used to treat anxiety disorder) are the highest in the world. They also have 700,000 reported Hikikomori [wikipedia.org] with estimated actual numbers of about 1% of the population. Meanwhile, suicide is the leading cause of death in males 20-44 years old. Yeah, it's just peachy there.